It's official. The Medical Council of India, the over five-decade-old body that was dissolved in 2010 following charges of corruption, and one that is being governed by a board of governors since last year, will now be replaced by a brand new National Medical Commission, 2019. This new body will regulate major aspects of medical education, including granting of permission to new colleges, determining fees for private medical colleges, ensuring quality standards and conducting the exit exam for the 70,000-odd MBBS students each year.
After breezing through the Lok Sabha, the National Medical Council Bill, 2019, was passed in the Rajya Sabha on Thursday, after a feisty debate in the upper house and protests by doctors across several hospitals over several contentious clauses.
Despite major opposition from doctors and medical students, one of the main contentions in the Bill—the clause that proposes to grant limited licences to about 3.5 lakh non-medical persons or community health providers—has stayed on. According to the clause, the CHPs will be able to provide primary care, and under the supervision of a doctor, secondary and tertiary care, too. Purportedly done to reduce shortages of doctors in rural areas and sub-centres, the clause attracted wide criticism, with a section of doctors arguing that this will dilute the quality of care. Union health minister Dr Harsh Vardhan told the upper house that the concept had been borrowed from the WHO and that it was prevalent in several countries including developed ones. "Twenty-one of the 25 members of the NMC are doctors and they will decide what will be the minimum qualification required to be a community health providers. This is a WHO-approved practice," he said.
On the issue of fee regulation, several members in the Rajya Sabha such as Jairam Ramesh, former Union minister for environment, said that states were already regulating fee for 85 per cent of the seats, and that there was no need to introduce the clause to frame guidelines for 50 per cent of seats. This would leave the rest of the seats free for respective college managements to decide whatever they wanted. To this, Vardhan responded by saying that the Indian Medical Council Act, 1956, did not have a specific provision for regulating fees, and that this clause would allow the government to frame guidelines for at least 50 per cent of the seats.
For the rest, the states could enter into an MoU with the private colleges and decide on the fee structure. He also assured the members that the government would take care of the issue while “framing the rules and regulations” after the Bill became a law, to avoid misuse of the fee clause, and introduce a cap for fees. Interestingly, Professor Ram Gopal Yadav, who was the chairperson of the parliamentary standing committee that recommended several changes in the Bill last year—and opposed the Bill on Thursday as well—supported the fee structure clause, arguing that if the fee for a majority of seats was regulated by the government, several private colleges would be forced to “shut down”.
On the subject of the NEXT exam, the minister clarified that the students clearing the licentiate exam would get a degree by their respective universities.
Vardhan also said that contrary to the perception in the house, the Commission had a fair representation for states (11 out of 25), as well as those from the medical profession (21 members are doctors out of the 25-member main body of the Commission).
On the issue of the status of about 100 MCI employees, who stand to lose jobs in the wake of the establishment of the new Commission, Vardhan said that a settlement would be discussed with them, and they would be treated with “compassion”.
